A new type of scan is almost 100 percent accurate in diagnosing breast cancer.

NEW SCAN ALMOST 100% ACCURATE IN IDENTIFYING BREAST CANCER

An estimated 1.4 million women undergo breast biopsies every year in the United States for abnormal findings on their mammograms, and approximately 85 percent of these suspicious mammographic findings will turn out to be benign following biopsy.

At the present time, breast imaging technology has not advanced enough to replace biopsy for most women with suspicious abnormalities noted on mammograms, or for women who develop palpable breast lumps.For example, MRI scans can detect 95 to 98 percent of early breast cancers, but MRI is also associated with a very high “false-positive” rate, in which as many as 25 percent of identified abnormalities turn out, after biopsy, to be benign.In an ideal world, a “perfect” breast scan would accurately identify 100 percent of cancers and 100 percent of benign breast lesions, but such a scan does not exist at this time.However, a new technology for scanning small cores of breast tissue removed during a needle biopsy may bring us closer to that “perfect” breast scan.

A newly published study suggests that a novel imaging technology may be able to accurately distinguish benign from cancerous breast cells within core needle breast biopsy specimens with almost 100 percent accuracy.This study appears in the current issue of the journal Cancer Research.

In this study, a device known as a spectroscope was used to scan core needle breast biopsy tissue specimens from 33 women.Pathologists then evaluated these same biopsy specimens and compared their microscopic diagnoses with the findings of the spectroscopic examination.

Using an analytic method known as the Raman algorithm, spectroscopic evaluation of these needle biopsy breast tissue specimens was shown to be almost as accurate as the pathologists’ diagnoses.Among the biopsy tissue samples that were identified as having cancer by Raman spectroscopy, 100 percent turned out to be cancer.Among the biopsy tissue samples that were identified as being benign (i.e., no cancer) by Raman spectroscopy, 96 percent turned out to be benign, while 4 percent contained cancer, based upon the pathologists’ findings

This new noninvasive imaging technology offers a number of potentially important benefits to patients with abnormal mammogram findings, as well as, potentially, women who are undergoing breast-conserving surgery (i.e., lumpectomy) for confirmed breast cancer.

For women who are undergoing needle biopsy of their breast following an abnormal mammogram, Raman spectroscopy of core needle biopsy specimens may allow the Radiologist performing the biopsy to determine, in real time, the results of such biopsies, rather than waiting for a week or longer for the Pathologist to report a formal diagnosis.Raman spectroscopy may also assist the Radiologist in determining whether or not the core needle biopsy has been accurately and adequately performed, based upon the spectroscopic “signature” of the breast tissue recovered from the needle biopsy.

There is also great interest in using Raman spectroscopy to more accurately determine the adequacy of lumpectomy when performing breast-conserving surgery for confirmed breast cancer.At the present time, 25 to 40 percent of patients with very small breast cancers have to undergo repeat lumpectomy due to the presence of cancer cells at (or close to) the edges of the lumpectomy breast tissue specimen, as seen under the microscope by the Pathologist.There is, at this time, preliminary data suggesting that Raman spectroscopy may be useful, in the operating room, to identify areas (“margins”) on the lumpectomy breast tissue specimen where tumor cells are too close to the surface of the specimen, thus allowing the surgeon to take additional breast tissue in these suspect areas at the time of the original lumpectomy surgery.In the best case, this novel approach to breast-conserving surgery may spare many women with breast cancer the need for a second (or third) breast lumpectomy.

As a cancer surgeon who cares for a large number of breast cancer patients, I find this novel and noninvasive imaging technology to be very exciting, and full of potential promise and benefit to patients with abnormal mammograms, as well as patients who have already been diagnosed with breast cancer.

According to recent Bureau of Labor Statistics, the unemployment rate for veterans who served on active duty between September 2001 and December 2011 is more than 12 percent. A new website, Veterans in Healthcare, seeks to connect veterans with potential employers. If you are a veteran who works in the healthcare field, or if you are an employer who is looking for physicians, advanced practice professionals, nurses, corpsmen/medics, or other healthcare professionals, then please take a look at Veterans in Healthcare. As a retired veteran of the U.S. Army, I would also like to personally urge you to hire a veteran whenever possible.

Disclaimer: As always, my advice to readers is to seek the advice of your physicianbeforemaking any significant changes in medications, diet, or level of physical activity

Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author

I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month. Over the past 12 months, 3.2 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious readers. As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.

A new study finds that women in their 40s with dense breasts benefit from annual mammograms.

WOMEN IN THEIR 40s MAY BENEFIT FROM ANNUAL MAMMOGRAMS

The U.S. Preventive Services Task Force (USPSTF) ignited a firestorm of controversy in 2009 when the government agency recommended that most women between the ages of 50 and 74 should undergo screening mammograms every other year,instead of every year.Even more controversial was the USPSTF’s recommendation that most healthy women between the ages and 40 and 49 should no longer undergo routine screening mammograms.Numerous cancer advocacy groups, including the American Cancer Society, subsequently recommended that the USPSTF’s revised guidelines for screening mammograms should, essentially, be ignored, and that women with an average risk of developing breast cancer should continue to undergo annual screening mammograms starting at age 40.

In 2010, following the USPSTF’s controversial recommendations, a significant drop in the number of annual screening mammograms performed on women in their 40s was observed, leading to concern among some breast cancer experts that many cases of breast cancer might go undiagnosed among 40 to 49 year-old women.

Now, a newly published study, which appears in the online edition of JAMA Internal Medicine, provides important new data regarding the potential impact of switching from annual screening mammograms to every-other-year (biennial) mammograms.

In this very large study, researchers analyzed prospectively collected data from mammography facilities throughout the United States that participated in the Breast Cancer Surveillance Consortium.Data was prospectively collected on 11,474 women who had been diagnosed with breast cancer and 922,624 women without breast cancer.

The findings of this enormous public health study strongly suggest that the USPSTF’s recommendations that women between the ages of 50 and 74 undergo every-other-year mammograms may actually be reasonable and safe.When compared to women in this age range who underwent screening mammograms every year, the women who underwent biennial mammograms did not have a higher incidence of advanced-stage breast cancers.An additional important finding was that even women aged 50 or older with very dense breast tissue, or women above 50 who had taken hormone replacement therapy, appeared not to experience any harm by undergoing biennial mammograms instead of annual mammograms.As both of these factors increase a woman’s lifetime risk of developing breast cancer, the finding of this study that women between 50 and 74 years of age can safely undergo screening mammograms every other year (instead of every year) is of particular significance.

In contrast to women between the ages of 50 and 74, this research study’s findings regarding women between the ages of 40 and 49 call into question the USPSTF’s recommendation that women in this age range need not undergo regular screening mammograms.Among the women in this study between the ages of 40 and 49, every-other-year screening mammograms (rather than every year) resulted in a significant increase in the incidence of more advanced-stage breast cancers.In fact, women in this age range, who often have very dense breast tissue, were 89 percent more likely to be diagnosed with advanced-stage breast cancers if they underwent every-other-year mammograms when compared to comparably aged women with dense breast tissue who underwent annual screening mammograms.

I consider this to be a very important clinical research study, and its findings may well lead to changes in the current recommendations regarding screening mammograms.At the same time, it will be important to follow the nearly one million women who participated in this public health study, to see if breast long-term cancer survival rates are impacted by the timing of screening mammograms (i.e., annual versus biennial mammograms).

It is critically important to avoid the multiple lifestyle and dietary factors known to increase the risk of breast cancer.For more research-based information on this important topic, please read the extended chapter on breast cancer in my bestselling book, A Cancer Prevention Guide for the Human Race.

According to recent Bureau of Labor Statistics, the unemployment rate for veterans who served on active duty between September 2001 and December 2011 is more than 12 percent. A new website, Veterans in Healthcare, seeks to connect veterans with potential employers. If you are a veteran who works in the healthcare field, or if you are an employer who is looking for physicians, advanced practice professionals, nurses, corpsmen/medics, or other healthcare professionals, then please take a look at Veterans in Healthcare. As a retired veteran of the U.S. Army, I would also like to personally urge you to hire a veteran whenever possible.

Disclaimer: As always, my advice to readers is to seek the advice of your physicianbeforemaking any significant changes in medications, diet, or level of physical activity

Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author

I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month. Over the past 12 months, more than 3.1 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious readers. As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.

Currently, women who are at an average risk of developing breast cancer are advised to undergo annual screening mammograms beginning at 40 to 45 years of age. Mammography, like any medical test, is not perfect (at least 10 to 20 percent of breast cancers will not show up on a mammogram among women who are at average risk for this type of cancer). Moreover, mammography, which relies upon low-powered x-rays to form images of the breasts, is especially challenged by women with dense breast tissue, which is, by itself, a known risk factor for breast cancer.

In many cases, the addition of ultrasound to mammography can help to form more accurate images of dense breast tissue, and is also useful for further evaluation of indeterminate breast abnormalities identified by mammography. (Also, both the lobular sub-type of breast cancer and small “low-grade” breast cancers tend to show up better on ultrasound than they do on mammograms.) Together, the combination of mammography and ultrasound can accurately detect approximately 85 to 90 percent of breast cancers in women with normal-density breast tissue; but, once again, in women with dense breast tissue (including most women under the age of 40), the sensitivity and overall accuracy of mammography plus ultrasound is often considerably decreased.

Magnetic resonance imaging, or MRI, has become a popular tool for breast imaging, although, like mammography and ultrasound, MRI of the breast has its downsides as well. MRI is known to be much more sensitive than either mammography or ultrasound in identifying breast cancers, with most studies showing a 95 percent or greater sensitivity associated with MRI. However, this exquisite sensitivity of breast MRI, as I discuss in my bestselling book, A Cancer Prevention Guide for the Human Race, is also associated with poor specificity (i.e., a high false-positive rate). Because of its poor specificity, MRI scans of the breast will be wrong, or falsely-positive, in 15 to 35 percent of cases where an abnormality is detected. Although there are other reasons as well, this high false-positive rate is the primary reason that MRI scans are not routinely used to screen for breast cancer.

As I have noted, none of these three common breast cancer screening tests are perfect, and each of them will miss some cancers that the other types of scans might pick up. With this information in mind, a newly published study, which appears in the current issue of the Journal of the American Medical Association, examines the potential role of ultrasound and MRI scans as supplements to screening mammograms in women who are at an increased risk for developing breast cancer.

In this prospective clinical research study, 612 women deemed to be at increased risk for breast cancer underwent three years of annual breast cancer screening exams with mammography and ultrasound. After completing these three years of annual screening with mammography and ultrasound, these women additionally underwent MRI scans of their breasts. Abnormalities suspicious for cancer, based upon any of these three diagnostic tests, were further evaluated by biopsy. This cohort of women volunteers was then followed for an additional 12 months, to monitor them for any signs of interval development of breast cancer.

The 612 women who underwent mammography, ultrasound and MRI screening were also part of a larger group of 2,662 high-risk women (54 percent of whom had a personal history of a prior breast cancer) who enrolled in this study, and who underwent annual breast cancer screening with both mammography and ultrasound. Altogether, 110 of these 2,662 women were diagnosed with a new breast cancer during the course of this prospective clinical research study.

The results of this study clearly illustrate the limitations of currently available breast cancer screening tests, particularly among high-risk women. Following three years of annual screening, only 52 percent of the breast cancers that arose were detected by mammography alone in these high-risk women, although the false-positive rate of mammography was very low, at 9 percent. The addition of ultrasound to mammography improved the sensitivity, or detection rate, to 76 percent, with a false-positive rate of 16 percent. When MRI was added to mammography and ultrasound, the detection rate (sensitivity) for breast cancer improved, significantly, to 100 percent, although the false-positive rate increased greatly due to the poor specificity of MRI and, to a lesser extent, ultrasound. When these three breast imaging modalities were combined, 35 percent of the abnormalities identified turned out to be benign lesions, and not cancer, following biopsy or other confirmatory diagnostic procedures.

This study confirms that essentially 100 percent of detectable breast cancers can be identified using a combination of mammography, ultrasound and MRI. However, this high level of sensitivity comes at a significant cost in that more than one-third of the abnormalities identified by the combined use of these three breast imaging modalities will, upon further testing, including biopsy, turn out to be completely benign. Therefore, this high false-positive rate, particularly associated with breast MRI, is the Achilles heel of this combined imaging approach to breast cancer screening.

Fortunately, there are emerging new breast imaging technologies that appear to have the same very high sensitivity rate as MRI, while maintaining the high specificity (i.e., low false-positive) rate of mammography. Among these promising technologies are Breast-Specific Gamma Imaging and Positron Emission (PET) Mammography (also known as “PEM”). Ultimately, these newer technologies, as well as even newer technologies, will most likely someday replace the use MRI to screen for breast cancer.

Disclaimer: As always, my advice to readers is to seek the advice of your physicianbeforemaking any significant changes in medications, diet, or level of physical activity

Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author

I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month. (More than 1.3 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious people who visited Weekly Health Update in 2011!) As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.

Welcome to Weekly Health Update

“A critical weekly review of important new research findings for health-conscious readers”

MAMMOGRAMS PREDICT RISK OF

HEART DISEASE AND STROKE

In view of the growing concern about the potential adverse health effects of CT scans (including increased cancer risk), the enthusiasm for performing CT scans of the heart and coronary arteries, as a noninvasive method of diagnosing asymptomatic heart disease, has been decreasing.Now, an innovative clinical research study, which has just been published in the journal Obstetrics & Gynecology, has evaluated the potential value of mammograms (which use low-dose x-rays to screen for breast cancer) to predict the risk of cardiovascular disease.

Calcification of the arteries within the breast are detected in approximately 10 to 20 percent of mammograms, and the incidence of these vascular calcifications rise in proportion to a woman’s age.Previous clinical research studies have suggested that the presence of vascular calcifications on mammograms may be an important early indicator of cardiovascular disease risk.However, the clinical research data in this area has been somewhat inconsistent, to date.

In this prospective clinical research study, 1,919 women, with an average age of 56 years, who presented for routine annual screening mammograms were subsequently followed for 5 years.Data was collected regarding their cardiovascular disease risk factors, and their own personal history (if any) of cardiovascular disease, as well as the presence or absence of cardiovascular disease in family members.This data was collected at the beginning of the study, and was updated throughout the course of the study.

The findings of this study were quite dramatic.During the 5-year course of this study, 21 percent of the women who were noted to have vascular calcifications within the breast, on routine mammography, were found to have coronary artery disease, while only 5 percent of the women without vascular calcifications on mammography had clinical evidence of coronary artery disease.Among those women with no clinical evidence of coronary heart disease at the beginning of this clinical study, 6 percent of those with vascular calcifications eventually developed coronary artery disease during the brief 5-year course of this study (compared to 2 percent of the women without vascular calcifications of the breast).Moreover, among healthy women with no history of coronary artery disease at the beginning of this study, 58 percent went on to experience a stroke if they had vascular calcifications in the breast, while 13 percent of the women without vascular calcifications of the breast experienced a stroke during this 5-year study.

The findings of this clinical research study strongly suggest that vascular calcifications of the breast, in women who are undergoing routine annual screening mammograms, may be a powerful indicator of increased risk for both coronary artery disease and stroke.While larger and longer-term prospective clinical research studies should be performed to validate the findings of this relatively small clinical research study, the findings of this study are consistent with earlier studies that have also linked vascular calcifications of the breast with a significant increase in the risk of cardiovascular disease.Therefore, the results of this study suggest that there may be an important secondary role for screening mammograms, beyond early detection of breast cancer.As women who have evidence of arterial calcifications of the breast by mammography (when compared to women without vascular calcifications) appear to be nearly 4 times more likely to have coronary artery disease, and have more than 4 times the risk of stroke, the presence of vascular calcifications on screening mammograms should prompt patients and their physicians to look for risk factors that can be modified to reduce the risk of premature illness and death related to cardiovascular disease.

For a complete discussion of the potential impact of medical x-rays (including CT scans) on cancer risk, as well as important evidence-based approaches to cancer prevention, order your copy of my new book, A Cancer Prevention Guide for the Human Race. For the price of a cheeseburger, fries, and a shake, you can purchase this landmark new book, in both paperback and e-book formats, and begin living an evidence-based cancer prevention lifestyle today!

Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity

Dr. Wascher is an oncologic surgeon, a professor of surgery, a cancer researcher, an oncology consultant, and a widely published author

For a different perspective on Dr. Wascher, please click on the following YouTube link:Texas Blues Jam

I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people, from around the world, who visit this premier global health information website every month.(More than 1.2 million health-conscious people visited Weekly Health Update in 2010!)As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.

Mammograms Save Lives in Women with Family History of Breast Cancer

Welcome to Weekly Health Update

“A critical weekly review of important new research findings for health-conscious readers”

MAMMOGRAMS SAVE LIVES IN WOMEN WITH

FAMILY HISTORY OF BREAST CANCER

While the debate about whether or not routine screening mammograms can save lives continues in some circles, the clinical research evidence supporting mammograms as a lifesaving cancer screening exam continues to accumulate.Now, a newly published public health study, which appears in The Lancet Oncology, examines the survival benefit associated with routine screening mammograms in women who have a family history of breast cancer.

In this large multicenter prospective clinical research study, which was performed in the UK, 6,710 women between the ages of 40 and 42 were enrolled in this study, and were followed for an average of about 4 years.These women, who had at least some family history of breast cancer, underwent annual screening mammograms as part of this clinical research study.This study used two important control groups to assess the impact of regular annual screening mammograms on the risk of mortality in these young women.The first control group consisted of women who were at average risk for breast cancer (these women, themselves, served as the control group for the enormous UK Age Trial, which included more than 106,000 patient volunteers, and which recently reported a 10-year follow-up of its results).The second control group, against which these 6,710 women with an intermediate familial risk of breast cancer were compared, included young women from another large public health study that was performed in the Netherlands.

Among the 136 women who were diagnosed with breast cancer during the relatively brief course of this ongoing study, 77 percent were diagnosed by screening mammography, while 21 percent were diagnosed when they presented with a new breast lump (or with other clinical signs or symptoms of breast cancer).(Another 2 percent of patients failed to attend their scheduled screening mammograms, and subsequently developed clinical signs or symptoms of breast cancer.)

In this study (and as other studies have shown, even among women who are at average risk of developing breast cancer), breast cancers that were detected by annual screening mammograms were significantly smaller in size, and significantly less likely to be associated with the spread of cancer to the lymph nodes.In addition to these very important breast cancer prognostic factors, women who were diagnosed with breast cancer as a result of annual screening mammograms had much less aggressive appearing tumors under the microscope when compared to women who were diagnosed with breast cancer only after a lump, or other signs of breast cancer, appeared.

Based upon the findings of this newly published study, young women with even an intermediate risk of breast cancer, based upon having one or more relatives with breast cancer, were 20 percent less likely to die within 10 years when compared with a poorly screened, or unscreened, average-risk population of young women.Moreover, this survival advantage appeared to be directly related to annual screening mammograms, once all other breast cancer risk factors among these three populations of women had been considered.

For a complete discussion of the compelling scientific evidence linking routine screening mammograms with a decreased risk of death due to breast cancer, please see the extended clinical section on breast cancer in my new book, A Cancer Prevention Guide for the Human Race.

I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people, from around the world, who visit this premier global health information website every month.(As of 9/16/2010, more than 1,000,000 health-conscious people have logged onto Weekly Health Update so far this year!) As always, I enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.

Mammograms Between 40 and 49 Years of Age

Welcome to Weekly Health Update

“A critical weekly review of important new research findings for health-conscious readers”

OCTOBER IS NATIONAL BREAST CANCER

AWARENESS MONTH

MAMMOGRAMS BETWEEN 40 AND 49 YEARS OF AGE

Both patients and their physicians were stunned last year when the U.S. Department of Health and Human Services’ U.S. Preventive Services Task Force (USPSTF) recommended against routine annual screening mammograms in women between the age of40 and 49 years (as has been the standard recommendation in the United States, and in most countries around the world, for many years).The USPSTF’s recommendations quickly set off a firestorm of debate regarding the calculations and public health considerations used by the USPSTF to arrive at this surprising recommendation.Since the USPSTF released its recommendations in the fall of 2009, most breast cancer specialists and breast cancer advocacy groups have continued to recommend that women who are at average risk of developing breast cancer begin routine annual screening mammograms at age 40.

As I extensively discuss in my new book, A Cancer Prevention Guide for the Human Race, there is ample available clinical research data showing that screening mammograms detect breast cancer at an earlier stage than other commonly available screening methods, and that survival is improved in women in whom breast cancer is first detected by a mammogram (as opposed to the detection of a palpable or visible breast mass).

Now, a newly published large-scale public health study from Sweden, which appears in the current issue of the journal Cancer, offers further important evidence that the routine use of annual screening mammograms among women between 40 and 49 years of age significantly reduces the risk of dying from breast cancer.

In this enormous study, women between the ages of 40 and 49 years were separated into two groups, depending upon whether or not they underwent annual screening mammograms between 1986 and 2005 (the average duration of patient follow-up in this study was a very impressive 16 years).In this very powerful research study, young women who underwent annual mammograms accounted for 7.3 million “person-years” of observation, while the young women who did not undergo mammograms accounted for a similarly astonishing 8.8 million “person-years” of observation within this landmark public health study.

When the number of breast cancer deaths were assessed in both of these huge groups of young women, the women who underwent routine annual mammograms were found to be 29 percent less likely to die of breast cancer when compared to the young women who did not undergo annual mammograms!(In public health terms, this 29 percent observed reduction in the death rate due to breast cancer is highly clinically significant!)

This public health study, which encompassed the entire country of Sweden, is the largest mammography study of its kind, and its findings are both powerful and persuasive in defense of beginning routine annual screening mammograms at the age of 40 in women who are at average risk of developing breast cancer.It is my hope that the dramatic findings of this huge clinical study will now lay to rest any lingering doubts regarding the effectiveness of screening mammograms, beginning at 40 years of age, in reducing the risk of death due to breast cancer.

In recognition of Breast Cancer Awareness Month, I urge our tens of thousands of regular Weekly Health Update readers to join in the global fight against breast cancer.There are numerous organizations and groups, in virtually every community, that are sponsoring fundraising activities throughout October, including the Susan G. Komen Race for the Cure.Another opportunity to participate (and at no cost!) is to vote for the Dr. Susan Love Research FoundationArmy of Women project in the Pepsi Refresh competition!There are also many other worthwhile and deserving fundraising programs available for everyone to become involved in!

For an evidence-based discussion of the critical importance of breast cancer screening, including mammograms, in a cancer prevention lifestyle, order your copy of my new landmark book, “A Cancer Prevention Guide for the Human Race,” from Amazonor Barnes & Noble, Books-A-Million, Vroman’s Bookstore, and other fine bookstores!

Disclaimer: As always, my advice to readers is to seek the advice of your physicianbeforemaking any significant changes in medications, diet, or level of physical activity

Dr. Wascher is an oncologic surgeon, a professor of surgery, a cancer researcher, an oncology consultant, and a widely published author

For a different perspective on Dr. Wascher, please click on the following YouTube link:

I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people, from around the world, who visit this premier global health information website every month.(As of 9/16/2010, more than 1,000,000 health-conscious people have logged onto Weekly Health Update so far this year!) As always, I enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.